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Breast Reduction Surgery and a Free Nipple Graft

Posted on: December 19th, 2014
By: DrDelgado

Breast Reduction Options

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

★★★★★ Ratings: 4.74 -118 Reviews

Breast Size Matters

Dependent on how large a woman’s breasts are will determine which type of breast reduction surgery is recommended. It is imperative that a woman seeks a Board Certified Plastic Surgeon that specializes in breast surgery. The surgeon will be able to help her determine which procedure will give her the results she desires.

Women with extremely large breasts are divided into two groups, gigantomastia and macromastia. Gigantomastia is where more than 1500 grams needs to be removed from each breast and macromastia refer to women that need just less 1500 grams removed from each breast during breast reduction surgery, also known as a reduction mammoplasty.

Free Nipple Graft Versus the Pedicle Method

Dr. Delgado explains to his breast reduction patients that when such a large amount of tissue needs to be removed it may be necessary to perform a free nipple graft. A free nipple graft (FNG) is when the nipple areola complex is completely removed and transposed without a blood supply, skin and glandular pedicle.

The pedicle method is the preferred method for breast reduction; this is where the nipple areola complex remains intact and is moved higher on the breast mound, typically preserving sensation and function. However, a woman with gigantomastia and many with macromastia will be limited to how much the breast can be reduced. It is very difficult to protect the pedicle when large amounts of breast tissue are removed. Shaping a breast around a pedicle is very challenging, and the resulting shape may be disappointing.

Risks of the Free Nipple Graft

Some of the risks with a free nipple graft are:
• The graft might not look natural
• The color of the nipple areola complex may fade
• Loss of the ability to breast feed
• The graft might not survive
• Probable loss of sensation

Dr. Delgado has observed that some of his patients have regained sensation, but it could take up to six months. As far as the viability of the graft, he states his results have been excellent. In some cases they may have partial take but less than 1 percent loss.

Breast Reduction Free Nipple Graft

This is a 45-year-old San Francisco resident seen in the San Francisco office. She is 5 feet 5 inches, 220 pounds, with size GGG breasts. She underwent an inverted T free nipple breast reduction due to the extreme size of her breasts. She is seen four months after surgery with early healing, but note the nice size and shape of her breasts. She went from GGG to a D cup.

 

As a guideline, a woman who has over 20 cm from the inframmary fold to the nipple may be a candidate for the free nipple graft. Older women seem less concerned about loss of nipple sensitivity and will opt for the FNG in order to have a smaller size. This is a highly individualized procedure where an expert breast reduction surgeon needs to be consulted. Patient input is very important for the surgeon to help guide her in the right direction.

Dr. Delgado, a breast surgery specialist since 1989, has been performing breast reduction surgery for both men and women. The procedure for breast reduction for men is referred to as gynecomastia. Anyone suffering from large breasts is invited to call (415 898-4161) or email (info@dr-delgado.com), for more information or to schedule a personal consultation.


Can Breast Reduction Surgery be Combined With Other Procedures?

Posted on: November 14th, 2014
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

★★★★★ Ratings: 4.74 -118 Reviews

For San Francisco Bay Area women who decide to proceed with a reduction mammoplasty surgical procedure, it is not unusual for them to ask if other procedures can be done at the same time.

Dr. Delgado does multiple procedures frequently as long as the patient is healthy. For example, the popular Mommy Makeover can include a tummy tuck, liposuction and breast augmentation, breast lift or breast reduction. Men who elect to have male breast reduction surgery, known as gynecomastia, also frequently combine additional procedures.

Mommy Makeover

This is a 35-year-old resident of Mill Valley, California who presented to the Novato office in Marin County for evaluation of a tummy tuck (abdominoplasty). She had a large weight loss due to diet and exercise. She underwent a full tummy tuck, breast reduction and liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California.

 

Breast reduction is usually done as an outpatient procedure, however, if additional procedures are going to be added, an overnight stay will most likely be necessary. It is not surprising that many women choose to add procedures so that they can take advantage of their time off for recovery, and to save time and money. The amount of surgery to be done will depend on the patient’s health and Dr. Delgado’s evaluation of what is appropriate.

Dr. Delgado has his own private surgery center that offers his patients the best concierge care. Marin Cosmetic Surgery Center (MCSC) is accredited by Medicare and the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (Quad A), meaning it meets the highest of standards. In the rare event of a medical emergency, Novato Community Hospital is just steps away.

Patients who stay overnight will have a registered nurse who is certified in “advanced cardiac life support” (ACLS) and an additional staff member for further comfort and safety. The surgery center has its own entrance providing privacy for Dr. Delgado’s patients.

phoneDuring your initial consultation, Dr. Delgado will be glad to discuss any and all of your cosmetic surgery goals and determine what combination of procedures is feasible and safe. Call today (415 898-4161) or email (info@dr-delgado.com)for your personal consultation with Dr. Delgado and find out what options are available to you.


Medical Insurance Denied my Breast Reduction Surgery, Now What?

Posted on: October 30th, 2014
By: DrDelgado

 

Trying to get coverage for breast reduction surgery can be very challenging. Health insurance companies have lots of different guidelines that patients have to meet. It is important to know what coverage your particular insurance has as some policies have an exclusion for breast reduction surgery altogether.

If your policy does not exclude reduction mammoplasty surgery some of the requirements you might have to meet may be:
a minimum of breast tissue to be removed
• a report from a physical therapist for treatment
• a letter from your doctor describing symptoms and attempted treatments, such as prescribed analgesics
• Use of special bras

Even when all of the above criteria have been met, some insurance companies will still deny surgery. Possibly they are hoping you will give up. At this point Dr. Delgado requests an appeal. He has been very successful in getting an approval with this approach. Most insurance companies respond to an appeal by having a medical doctor call your surgeon to discuss the case. This is when it is imperative that your surgeon understand the ins and outs of the insurance companies and how to present your case.

Before and After Reduction Mammoplasty Surgery

Breast Reduction Before and After Reduction Mammoplasty Surgery

If you discover that your breast reduction surgery has been denied because it is not a covered procedure under your policy, none of the above conditions will make a difference. A solution might be to consider changing your insurance coverage during an open enrollment period. If you have your insurance through your employment perhaps your Human Resources representative can help you find a better policy.

Having insurance cover breast reduction surgery for men is even more frustrating. Insurance companies do not cover cosmetic surgery and there needs to be a lot of evidence that surgery is a medical necessity. Gynecomastia can be psychologically devastating for men, but unless there is physical pain involved, applying for coverage can be a fruitless endeavor.

Dr. Delgado has had many years of experience in helping patients obtain medical insurance coverage for breast reduction surgery. After an evaluation by Dr. Delgado, he will be able to tell you how likely it will be for you to get approval, and if you hit roadblocks he will be there to support you!

phoneCall (415 898-4161) or email (info@dr-delgado.com)today for a consultation for your breast reduction or breast revision needs.


Can Uneven Breasts be Corrected During Breast Reduction Surgery?

Posted on: September 26th, 2014
By: DrDelgado

vertical breast reduction

This is a 52-year-old patient who resides in San Francisco. She was seen in the San Francisco office at Union Square for a breast reduction. She is the mother of two children. She is 5 feet 5 inches, 140 pounds. She underwent a vertical short scar breast reduction in which her size was reduced from a DD to size C. In addition she had a tummy tuck and liposuction at Marin Cosmetic Surgery Center at the same time. This is also termed a mommy makeover. The photographs show her at approximately six months after surgery.

 

It is quite common for women to have uneven breasts. They may be uneven in volume or different nipple shape or size, or uneven nipple position or the breasts may be different shapes. Some women choose to live with their asymmetry while others seek options to even them out. Especially if the woman has a hard time finding bras to fit without having to pad one side, and/or finding clothes to fit properly.

Today there are many ways to achieve symmetry and have the breasts nicely contoured. During a consultation with Dr. Delgado, he will explain all options and determine what the patient wants her breasts to ultimately look like.

There are several reasons that the breasts may be asymmetric, including; location of the nipples, location of the breast fold, amount of breast tissue, previous biopsies, congenital deformities such as Poland syndrome.

For the woman that has uneven breasts, it is common to reduce one or enlarge one to achieve symmetry. There can be quite a combination of procedures to achieve this such as; a breast lift, breast reduction, breast implants and fat transfers.

In a study done by the American Society of Plastic Surgeons, women who have had surgery to correct breast asymmetry and/or breast reduction, have a significant increase in self-esteem. Dr. Delgado has found this to be true with his patients, over and over again.

Breast reduction in many cases is covered by medical insurance, depending on what procedure or combinations of procedures are done, it is possible that part or all of the surgery may be covered.

At the time of your consultation with Dr. Delgado, his patient coordinator, who is very experienced in dealing with insurance companies, can help you request coverage from your medical insurance.

If you have asymmetric breasts and/or are in need of a breast reduction, you are invited to call (415 898-4161) or email (info@dr-delgado.com) for a consultation with Dr. Delgado, who is a breast surgery specialist.

Dr. Delgado, a breast surgery specialist, has been doing all types of breast surgery; breast augmentation, breast lift, breast revision, breast reduction and male breast reduction, since 1988.


The Purpose of Drains After Breast Reduction Surgery

Posted on: August 11th, 2014
By: DrDelgado

JPdrain

San Francisco, California-Drainage tubes are placed at the end of several different major types of cosmetic plastic surgery, including but not limited to: gynecomastia (male breast reduction), tummy tuck surgeryand breast reduction, also known as reduction mammoplasty.

The purpose of a drain is to remove blood and lymphatic fluid from the operative site. This will help prevent infection and eliminate dead space created by removal of fat and breast tissue. Removing the accumulated fluids will also promote healing and recovery.

Jackson Pratt is the type of drain used after breast reduction surgery. It has a clear tube that runs from the surgical site to a bulb or reservoir. When the bulb is emptied it is gently squeezed when reattaching to the drain tube causing a low negative pressure suction that helps remove fluids. You will be asked to keep a log to measure output and color of the fluid.

Creating Suction

 

Prior to surgery, Dr. Delgado gives his patients  a detailed instruction booklet with extensive pre and post-operative instructions. In addition, prior to being released from Marin Cosmetic Surgery Center, in Marin County, California, the nurse will review all post op care, including a demonstration of measuring and emptying the bulb to you and your overnight caretaker. The amount of drainage and color of the fluid will determine when the drain can be removed, usually within 3 to 5 days.

If the patient notices: an unusual increase of fluid collection, bright red blood, fever and/or tenderness it must be reported immediately. It is possible for the drain tube to get blocked with a small blood clot. This can be remedied by pinching the tube above the blockage and sliding with a pinching of the thumb and forefinger of the other hand down the tube to the bulb. This will also be demonstrated.

The removal of the drain may cause some discomfort of a burning or stinging nature. Taking pain medication prior to removal is possible as long as the patient has someone to drive her home.

After removal of the drains, the small incision site will close up within 24 to 48 hours. Once they have closed up they are now waterproof and the patient may resume regular showers. However, while the drains are still in place, only sponge baths are allowed, and the incision site must remain dry to avoid infection.

Even with the minor discomfort that the drains may cause, they serve a great purpose in not only reducing the chance of infection, speeding up healing and recovery; they prohibit the buildup of fluids in the surgical site which would be much more painful.

Call today at (415) 898-4161 for a personal consultation with Dr. Delgado for breast reduction surgery.


Breast Reduction Approaches, How to Choose the Best

Posted on: July 18th, 2014
By: DrDelgado

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

 

 

The woman who has decided to proceed with breast reduction surgery is faced with other important decisions such as; when to have surgery, who will she depend on for assistance, how to pick her surgeon, and what breast reduction procedure will she opt for?

Dr. Delgado presents this blog to help women understand what their options are for the different approaches to breast reduction surgery.

 

The traditional (also known as the anchor or inverted T) breast reduction is considered the “gold standard” and is most often used for a woman with very large breasts. The incision goes around the nipple areola complex (NAC), then vertically down to the breast crease and continues horizontally along the breast crease. The resulting scar would be in the shape of an anchor or inverted T. The amount of breast tissue that needs to be removed will determine how the nipple is to be treated. Preferably, it will be what is referred to as the inferior pedicle technique. The inferior pedicle technique allows the NAC to remain attached by a bridge of breast tissue called a pedicle and is moved up on the breast mound after the reduction. This technique keeps intact nerve and blood supply and, therefore, in most cases the woman will have preservation of her nipple sensation. Unfortunately, a woman with very large breasts may not have this option and may need what is called a Free Nipple Graft; in this case the NAC is completely removed and after the reduction, is grafted back into the desired position. The downside to this procedure is that sensation and the ability to breast feed are lost.

 

T incision breast reduction, before and afterT incision after breast reduction surgery

This is a 57-year-old, female resident of Santa Rosa, California who presented to the Novato office in Marin County for an evaluation for a breast reduction. She has size DD breasts. She underwent a breast reduction using an inverted-T technique. In addition, she also had a tummy tuck with liposuction of the flanks for improvement of her post-childhood years. She underwent the inverted-T breast reduction and tummy tuck with liposuction at Marin Cosmetic Surgery Center in Marin County, California. Note the nice shape to her breasts and her overall improved body proportions. These photos were taken one year after surgery.

The short scar (also known as the vertical) breast reduction is a popular procedure for women with moderately sized breasts. There is less scarring as the horizontal incision at the crease of the breast is avoided, resulting in what is referred to as a lollipop incision. This incision goes around the NAC and then vertically from the base of the nipple to the crease.

 

Scarless (liposuction) breast reduction is becoming increasingly popular as the technique for reduction with liposuction continues to improve. The advantages are many, scarring is minimal, recovery is much easier and the possibility of complications is greatly reduced. This option is usually for a woman with mild to moderate breast tissue that has a high fat ratio. However, if a large amount of fat is removed the skin will only contract to a limited extent and then will sag. When reducing the breasts by liposuction alone, there will not be any lifting of the breasts as can be achieved with traditional breast reduction.

 

This information is not meant to further confuse a woman as to what procedure is best for her, but to point out that there are various options and decisions to be made. A Board Certified Plastic surgeon that specializes in breast surgery will be able to inform a woman as to which choices she may be a candidate for and what results she can expect. It is a very individualized procedure; a consultation and exam will provide answers to your questions.

 

As an expert in breast surgery since 1989, Dr. Miguel Delgado has a vast amount of experience in helping women choose the best reduction mammoplasty procedure. His reviews speak for themselves as this video portrays.

 

If you are seeking more information about breast reduction and want to know what your options are, call today (415 898-4161) or email (info@dr-delgado.com) to schedule a consultation with Dr. Delgado at his San Francisco or Marin County office. If you have medical insurance, Dr. Delgado and his staff will be able to assist you in obtaining authorization.


Can the Breasts be Reduced to Any Size with Breast Reduction Surgery?

Posted on: June 18th, 2014
By: DrDelgado

Breast Reduction 45

This is a 45-year-old San Francisco resident seen in the San Francisco office. She is 5 feet 5 inches, 220 pounds, with size GGG breasts. She underwent an inverted T free nipple breast reduction due to the extreme size of her breasts. She is seen four months after surgery with early healing, but note the nice size and shape of her breasts. She went from GGG to a D cup.

 

It is very possible to achieve the desired size breasts with breast reduction surgery.

For most women, the main goal is to have enough tissue removed to alleviate the symptoms caused by large breasts, i.e., shoulder, back and neck pain.

Another issue women have is that they want to be able to buy clothes “off the rack.”

In addition, another major concern is how shapely will the new breasts be and how visible are the resulting scars?

Some women are so frustrated with their large breasts they ask for the extreme of having them removed, as in a mastectomy. However, it needs to be stated that for a drastic reduction there is more potential for complications. When huge amounts of tissue are removed, consideration must be given to the effect of blood supply and nerve supply of the breast.

Every patient is unique and needs to have excellent communication with her surgeon to understand what is possible in reaching her goals.

Looking at many before and after pictures with your surgeon can help you understand what results you might expect. There are different techniques for breast reduction surgery, and each will give different resulting shapes.

For the various options available to each patient, it is of utmost importance that a woman chooses a Board Certified Plastic surgeon that is an expert in breast surgery.

Dr. Miguel Delgado has been perfecting his breast surgery skills since 1988 with such procedures as; breast augmentation, breast lift, breast revision, breast reduction for women and male breast reduction also known as gynecomastia.

phoneToday, Dr. Delgado is considered as an expert breast surgeon, and he invites you to call (415 898-4161) or email (info@dr-delgado.com) to schedule a consultation at his San Francisco or Marin County office. At the consultation, Miguel Delgado, M.D. will perform a detailed examination after which he will be able to give you his expert advice as to what procedure will give you your desired result. If you have medical insurance, Dr. Delgado and his staff will be able to assist you in obtaining authorization.


Breast Reduction, Why Bigger Isn’t Always Better

Posted on: December 30th, 2013
By: DrDelgado

breast reduction b&a

This is a 32-year-old resident of San Rafael, California who was seen in the Novato office in Marin County. She is 5 feet 4 inches, 130 pounds, and underwent a short scar vertical breast reduction at the Marin Cosmetic Surgery Center. Her size was reduced from a size F to a size C. The photographs are seen approximately nine months after surgery and the incisions are starting to fade quite nicely.

 

 

San Francisco, California-There are many things that Americans notoriously deem “the bigger the better” such as; houses, boats, swimming pools, food portions, drinks, and women’s breasts.

According to the American Society for Aesthetic Plastic Surgery (ASAPS), in 2012 there were over 330,000 women that had breast augmentation surgery and over 112,000 women that had breast reduction or reduction mammoplasty surgery. So while many women are going bigger, a third as many are going smaller.

Breast enhancement surgery is a wonderful procedure for the woman who feels out of proportion with small breasts. There is no doubt that breast augmentation can raise a woman’s self-confidence, especially for filling out her clothes or a bathing suit. It may come as a surprise to learn that breast reduction can bring the same rewards and even more for many women.

Breast reduction surgery is rated one of the highest in patient satisfaction of all elective surgeries performed for women, as gynecomastia (male breast reduction) is for men. Many women have been surveyed, and the unanimous results showed the top reasons they agreed that bigger is not better are:

1.    The immediate relief from back, neck and shoulder pain. Women with large breasts that are carrying extra weight on their chests find that if they do not have enough support from surrounding muscles it becomes very difficult to maintain good posture, which can lead to spinal deformity. Many women who are self-conscious about their large breasts tend to roll their shoulders forward in an attempt to hide their breasts, which can make their back pain even worse.

2.    The ability to participate in more physical activities and exercise. Women have reported that working out in a gym or jogging was almost impossible for any length of time. Participating in sports events can be embarrassing with large bouncing breasts. After breast reduction surgery, many found that they were able to get into better physical condition and lose weight.

3.    No longer having long sagging breasts that made a woman appear 20 years older. Reduction mammoplasty gives a woman more youthful perky breasts.

4.    More clothing options. Most post-surgical breast reduction patients love to go shopping for clothes they can now buy off the rack and not just from specialty shops that sell unflattering extra-large tops.

5.    Having eye contact with the opposite sex was a new experience and highly rated among breast reduction patients. No longer did men focus on their chests causing them great embarrassment.

6.    The end of chafing and uncomfortable red rashes caused by breasts rubbing against each other and under the breast fold was a huge relief for many women.

The benefits of breast reduction surgery aren’t as widely known as breast augmentation surgery as many people think having large breasts is a blessing. Even insurance companies understand the medical necessity to the point that many will cover the procedure. Not to say that getting insurance to cover the procedure is easy, on the contrary, insurance will make the patient jump through many hoops for the patient to get approval. Therefore, the patient should seek out a Board Certified Plastic Surgeon that specializes in breast surgery to assist the patient in obtaining approval. The effort is well worth it as most women will agree.

Call today for a consultation with Dr. Delgado, a specialist in breast reduction surgery at (415) 898-4161 or email.


Physical and Psychosocial Well-being Improvements for Breast Reduction Patients

Posted on: November 30th, 2013
By: DrDelgado

Before and After Breast Reduction of Miguel Delgado,MD

This is a 23-year-old resident of San Francisco and seen in the Marin County Office for a breast reduction. She is 5 feet 2 inches, 167 pounds. She underwent an inverted T breast reduction at the Marin Cosmetic Surgery Center. She went from a size DDD to a C cup in size. The photographs are approximately nine months after surgery. Note the nicely fading incisions.

San Francisco, California-The American Society of Plastic Surgeons (ASPS) is the largest plastic surgery specialty organization in the world, representing more than 94% of all Board Certified Plastic Surgeons in the United States.

“Plastic and Reconstructive Surgery” is the medical journal of ASPS where a recent study was reported on the health benefits (both physical and mental) for breast reduction patients. This study was done to justify the necessity of breast reduction surgery to the insurance companies. For purposes of evaluation, “Breast Q”, which is a well validated questionnaire, was used in this study.

The study included 49 patients that were preparing to undergo breast reduction surgery. Of the 49 women, there were 78% who completed the questionnaire either before or after their reduction mammoplasty surgery. Satisfaction with surgery and quality of life issues were evaluated in four areas; appearance, psychosocial, sexual and physical well-being. Not surprisingly, the study showed significant improvement in all four areas. Based on a scale of 100, the improvement for each area was reported as follows:

1.    Satisfaction with breast appearance went from 20 to 80 after surgery

2.    Psychosocial well-being was 41 and increased to 84

3.    Sexual well-being went from 40 to 78

4.    Physical well-being was 43 and increased to 81, noting great relief of pain in the breast, back, neck and shoulders.

Appearance of the breasts showed the greatest satisfaction with the overall outcome of the surgery. Women stated they slept better and had greater ability to exercise, in addition to the reduction of pain.

Medical insurance companies notoriously have many conditions the patients must meet in order to get coverage for surgery. For example, many insurers require that the patient has documented proof that they have tried; physical therapy, good support bras, analgesics, and most require the need of a minimum of 500 grams of breast tissue to be removed.

The study also determined that for many, improvements occurred for women that had small reductions, which disputes the insurance coverage guidelines for a mandatory amount to be removed. Researchers plan to continue with additional studies with more patients and a longer term follow up.

Presently, the only way to know if your insurance will cover reduction mammoplasty surgery is to call them. Have your I.D. number available. Don’t be surprised if the answer is “that depends”, at this point it is recommended that you see a Board Certified Plastic Surgeon that specializes in breast surgery, to help you with the ins and outs of obtaining approval for surgery.

The Affordable Care Act, also known as “Obama Care” is probably going to continue to change as it moves forward, with Congress arguing over each detail. It is impossible to know how the Affordable Care Act will affect breast reduction surgery approvals in the future.

In addition to breast reduction, many patients are now choosing to have some areas of fat reduced by CoolSculpting which is now available to Dr. Delgado’s patients. CoolSculpting is a non-surgical treatment that can reduce stubborn pockets of fat that resist reduction by diet and exercise. For a consultation call today at (415) 898-4161 or email.


Will Exercise Reduce and/or Lift My Breasts?

Posted on: October 21st, 2013
By: DrDelgado

San Francisco, CA-There are several reasons that women look for alternatives to breast reduction other than surgery.

Some women are fearful of surgery, some are fearful of anesthesia, while others are concerned about the time that they would need to take out of their busy schedules for recovery. The financial expense for women who do not have coverage by medical insurance can be prohibitive. Then there are women who worry about what their breasts may look like after a reduction mammoplasty surgery.

For all of these reasons and more, women look for ways of reducing their large breasts that does not involve surgery.

The breast is composed of fat and breast tissue, the ratio varies greatly among women. For those with a greater degree of fat, weight loss can make a big difference. If the woman does not have good skin elasticity, the breast may end up looking deflated and droopy after significant weight loss.   woman lifting weights

There have been a great number of inquiries asking if exercise can make a difference in breast reduction and possibly help to lift the breasts. As mentioned the breast is made up of fat and breast tissue, not muscles. Exercise may strengthen the underlying pectoralis muscles, but the breast is supported by a network of suspensory ligaments which are not affected by exercise.  Due to gravity and the loss of integrity of the connective tissue support over time, the weight of the breasts will diminish the ligament support to the chest wall, and the breasts will droop.

Men with gynecomastia (male breasts) hope to reduce their man boobs through exercise. They find the same thing that women do, it doesn’t work. In some cases, the development of the pectoralis muscle may even make the breast more prominent by pushing the breast out further beyond the muscle.

The breast gland sits on top of the muscle and is not affected by how strong the underlying pectoral muscle is and strengthening the pectoral muscle will not alleviate back and neck pain. Weight loss and exercise are helpful for tone but not tightening. Exercise could help strengthen the back muscles which could help support the extra weight of the breasts on the chest.

In the search for alternative methods of breast reduction, women may find expensive pills, creams and lotions advertised on the internet. Some state they are granted “GRASE” status by the FDA, which means the herbal ingredients are safe, not that the product works, if it worked, no one would have surgery.

Getting the right support bra from a specialty store is not a permanent solution, but with good support some of the heaviness and back pain may be alleviated.

Many women have gotten good results from a less invasive procedure, liposuction, but not all women are candidates. The best candidate for liposuction breast reduction is the woman who has minimal to moderate breast enlargement, a larger fat to breast tissue ratio, with minimal sagging; usually it is the younger woman with normal skin elasticity. Liposuction can significantly reduce the breast size for this patient with less pain, a shorter surgery and faster recovery. However, when the fat is removed the skin may not contract fully, and the breast may sag. In addition, the breast will not be lifted as in a traditional breast reduction. With all this being said, breast reduction surgery remains one of the most patient pleasing surgical procedures.